Individual
ANTHONY KALEEL DYSON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
230 VETERANS BLVD, DENHAM SPRINGS, LA 70726-4725
(225) 349-7960
Mailing address
9369 W TAMS DR, BATON ROUGE, LA 70815-8957
(225) 529-7079
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
011750957
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
868966348
UNITEDHEALTHCARE
LA
Enumeration date
05/28/2019
Last updated
05/28/2019
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